FAKTOR MANAJERIAL YANG MEMPENGARUHI LAYANAN LUAR GEDUNG PUSKESMAS PERKOTAAN DAN PEDESAAN (ANALISIS DATA IFLS EAST 2012)
VERONIKA SUKA, Dr. dr. Mubasysyir Hasanbasri, MA; Retna Siwi Padmawati, MA
2015 | Tesis | S2 Ilmu Kesehatan MasyarakatLatar Belakang : Program pelayanan kesehatan masyarakat luar gedung puskesmas dapat diukur melalui beberapa indikator yaitu promosi kesehatan, kesehatan lingkungan, kesehatan ibu dan anak, gizi masyarakat dan pemberantasan penyakit menular. Pendekatan kemasyarakatan merupakan komponen layanan puskesmas yang disebut dengan public health di tingkat local. Kegiatan pokoknya adalah integrasi layanan preventif dan kuratif, mempertimbangkan sosial ekonomi dan budaya determinan kesehatan, mengidentifikasi kebutuhan dan menyediakan layanan kesehatan masyarakat. Tujuan utama dari primary health care adalah equity dan partisipasi beberapa faktor penting mengukur partisipasi yaitu need assessment, leadership, organisasi, mobilisasi sumber daya, managemen dan fokus atau pro poor. Dengan demikian manajemen layanan luar gedung menjadi sangat penting, sebagai ukuran untuk menilai sejauh mana organisasi puskesmas membuka akses partisipasi masyarakat dalam pratek kesehatan, baik preventif, promotif maupun kuratif. Tujuan : Untuk mengetahui apakah fakor manajerial dapat mempengaruhi layanan luar gedung puskesmas perkotaan dan pedasaan. Metode : Penelitian ini adalah penelitian analisis lanjutan data IFLS tahun 2012 dengan rancangan cross-sectional. Data IFLS 2012 diolah dengan komputer dan dilakukan analisis univariat, bivariat dan multivariat dengan α = 0,05. Regresi logistik digunakan untuk mengidentifikasi faktor manajerial yang mempengaruhi layanan luar gedung puskesmas. Unit analisis penelitian ini adalah Kepala puskesmas yang menjadi sampel dalam data IFLS East 2012. Hasil: kepala puskesmas profesi bukan dokter yang berada di desa lebih sering melakukan kegiatan lapangan di luar gedung puskemas dibandingkan yang berprofesi dokter yang berada di kota. Pelayanan luar gedung puskesmas dilihat pembagian wilayah puskesmas yang berada di desa dan puskesmas yang di kota menunjukan bahwa kegiatan lapangan seperti posyandu dan penyuluhan 37 kali lebih sering dilakukan oleh kepala puskesmas yang berprofesi bukan dokter yang berada di desa. Puskemas dengan jumlah tenaga medis ≥ 15 orang dan lokasinya di pedesaan kepala puskesmasnya lebih sering melakukan kegiatan lapangan berupa posyandu dan penyuluhan. Kesimpulan: Kepala Puskesmas dengan profesi dokter lebih sering melakukan kegiatan luar gedung untuk kegiatan administrasi seperti rapat dan seminar. Kepala puskesmas yang berprofesi bukan dokter lebih sering melakukan kegiatan luar gedung berupa kunjungan lapangan berupa penyuluhan dan posyandu. Puskesmas dengan jumlah staff yang banyak kepala puskesmas lebih sering melakukan kegiatan kegiatan lapangan berupa penyuluhan dan posyandu. Puskesmas yang berada di lokasi pedesaan lebih banyak kegiatan luar gedung dibandingkan dengan puskesmas yang ada diperkotaan.
Background: The program of public health services outside the health center can be measured by several indicators of health promotion, environmental health, maternal and child health, community nutrition and the eradication of infectious diseases. The approach is a component of community health center services are called public health at the local level. Main activity is the integration of preventive and curative services. Considering the socio-economic and cultural determinants of health, identifying needs and providing public health services. Since the main purpose of primary health care is equity and participation. In measuring participation, there are several important factors that need assessment, leadership, organization, resource mobilization, management and pro-poor focus . Achieving equity in health is closely related to access to public participation by taking into account several factors above. Thus the management of the service outside the building to be very important, as a measure to assess the extent of organizational health centers open access community participation in health pratek, either preventive, promotive and curative. Objective: To determine whether managerial faktor can affect the service outside the urban and rural health centers. Methods: The study was a quantitative study using secondary data IFLS 2012 with cross sectional survey. The population in this study is the Head of the health center of the data IFLS East 2012, which spread across 7 provinces in Eastern Indonesia ,. Number of heads of health centers in the year 2012 as a whole that is in 7 province which in 1690 .. The total sample is the head of as many as 97 health centers Health Center Chief of the data IFLS East 2012, which spread across 7 provinces in East Indonesia, East Nusa Tenggara, East Kalimantan, Southeast Sulawesi, Maluku, North Maluku, West Papua and Papua. The method of determining 7 province in eastern Indonesia based on Susenas July 2010. Results: The head public health center (PHC) profession not a doctor in the village more often field activities outside the health center than a doctor who works in the city. Outside the building services division of health center visits in the village health centers and primary health centers in the city shows that the field activities such as Posyandu and counseling 37 times more often done by puskesmas head who is not a doctor in the village. PHC the number of medical personnel ≥ 15 people and rural location in the PHC head more often field activities such as posyandu and counseling. Conclusion: The head of the health center with the medical profession often do activities outside the building for administrative activities such as meetings and seminars. Puskesmas head who is not a doctor more frequently outside the building activities such as field trips in the form of counseling and posyandu. Health Center with a number of heads of health center staff much more frequently conducting field activities such as counseling and posyandu. PHC with a number of heads of health center staff much more frequently conducting field activities such as counseling and Posyandu. PHC located in a rural location outside the building more activities compared to the existing urban health centers.
Kata Kunci : Faktor Manajerial, Upaya Luar Gedung Puskesmas
